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. 2014 Jul;58(4):430-5.
doi: 10.4103/0019-5049.138979.

A prospective randomised double blind study of intrathecal fentanyl and dexmedetomidine added to low dose bupivacaine for spinal anesthesia for lower abdominal surgeries

Hem Anand Nayagam  1 , N Ratan Singh  1 , H Shanti Singh  1
Affiliations

A prospective randomised double blind study of intrathecal fentanyl and dexmedetomidine added to low dose bupivacaine for spinal anesthesia for lower abdominal surgeries

Hem Anand Nayagam et al. Indian J Anaesth. 2014 Jul.

Abstract

Background and aims: The potentiating effect of short acting lipophilic opioid fentanyl and a more selective α2 agonist dexmedetomidine is used to reduce the dose requirement of bupivacaine and its adverse effects and also to prolong analgesia. In this study, we aimed to find out whether quality of anaesthesia is better with low dose bupivacaine and fentanyl or with low dose bupivacaine and dexmedetomidine.

Methods: This prospective randomised double-blinded study was carried out in a tertiary health care centre on 150 patients by randomly allocating them into two groups using a computer generated randomisation table. Group F (n = 75) received bupivacaine 0.5% heavy (0.8 ml)+fentanyl 25 μg (0.5 ml) + normal saline 0.3 ml and Group D (n = 75) received bupivacaine 0.5% heavy (0.8 ml) + dexmedetomidine 5 μg (0.05 ml) + normal saline 0.75 ml, aiming for a final concentration of 0.25% of bupivacaine (1.6 ml), administered intrathecally. Time to reach sensory blockade to T10 segment, peak sensory block level (PSBL), time to reach peak block, time to two segment regression (TTSR), the degree of motor block, side-effects, and the perioperative analgesic requirements were assessed.

Results: There were no significant differences between the groups in the time to reach T10 segment block (P > 0.05) and TTSR (P > 0.05);time to reach PSBL (P < 0.05) and modified Bromage scales (P < 0.05) were significant. PSBL (P = 0.000) and time to first analgesic request (P = 0.000) were highly significant. All patients were haemodynamically stable and no significant difference in adverse effects was observed.

Conclusion: Both groups provided adequate anaesthesia for all lower abdominal surgeries with haemodynamic stability. Dexmedetomidine is superior to fentanyl since it facilitates the spread of the block and offers longer post-operative analgesic duration.

Keywords: Dexmedetomidine; fentanyl; low dose bupivacaine; opioids; spinal anaesthesia.

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Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Intergroup comparison of systolic blood pressure
Figure 2
Figure 2
Intergroup comparison of diastolic blood pressure
See this image and copyright information in PMC

References

    1. Kim SY, Cho JE, Hong JY, Koo BN, Kim JM, Kil HK. Comparison of intrathecal fentanyl and sufentanil in low-dose dilute bupivacaine spinal anaesthesia for transurethral prostatectomy. Br J Anaesth. 2009;103:750–4. - PubMed
    1. Fournier R, Van Gessel E, Weber A, Gamulin Z. A comparison of intrathecal analgesia with fentanyl or sufentanil after total hip replacement. Anesth Analg. 2000;90:918–22. - PubMed
    1. Gutstein HB, Akil H. Opioid analgesics. In: Gilman AG, Hardman JG, Limbird LE, editors. Goodman and Gilman's the Pharmacological Basis of Therapeutics. 10th ed. New York, NY: McGraw Hill; 2001. pp. 595–6.
    1. Reves JG, Glass PS, Lubarsky DA, McEvoy MD, Martinez-Ruiz R. Intravenous anesthetics. In: Miller RD, editor. Miller's Anesthesia. 7th ed. Philadelphia: Elsevier, Churchill Livingstone; 2010. pp. 751–7.
    1. Dahlgren G, Hultstrand C, Jakobsson J, Norman M, Eriksson EW, Martin H. Intrathecal sufentanil, fentanyl, or placebo added to bupivacaine for cesarean section. Anesth Analg. 1997;85:1288–93. - PubMed